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L. <br /> 010174 ❑885 Jannis Drive■Margam Hill,CA 95W7,-(463)77&9 `PAX(448)78R-1730B <br /> 819 Stalker Ave„Suite 8•$&orementa,CA 95834•(9 10)921-9600+FAX(9 16)921-0100 w, <br /> F)404 N.Wtget Lane■Walnut Creek,GA 94598 ■(925)988.9600■FAX(925)988-8673 ` <br /> TOZ)U U ❑1455 McDowell Blvd.hrarlh,Suite 0■Patalumar CA 94954•(707)702.1865.1~AX(707)792-0312 I <br /> 1551 Industrial Road■Burr Carlos,CA 94070*(660)232-9640■FAX(650)232-9612 ;. <br /> Consultant Company: 6 - c r-� r - Tosco Engineer. 3 <br /> Atldrass= 1 J} F R 17vire Y f Site� ---- -- <br /> City: Slue: Grp Qxfe: q Site Address: WOO dfr f/ei <br /> Telephone:110)79'q— 0 Fax 4'170-1 Email I fF 1 City,Slate: r&6 <br /> Report To: ( V$ Sampler. M Data: NJ Level D(Standard) IlLevel G E]Level' <br /> 8 Q Level A <br /> [? <br /> Turnaround 10 Work Days p 5 Work Days p 3 Wcrk Days E7 Drinking Water Analyses Requested Y <br /> Ti2 Work Days f ] 1 Work Day []2-8}lours E]Waste Water @�r, �,�� <br /> me: S <br /> ❑DtherCL <br /> !a Oz o <br /> Project Coding: <br /> Clrenl Datoljlma Matrix #of Coni. Sequoia`s <br /> Sarriplo I.D. Sampled {baso. Cant, Type Sam Comments y . <br /> �. UIQ— 0 Wrie + l <br /> 2. <br /> a7. <br /> 4. 4 <br /> 5. <br /> ti- <br /> 6. ti <br /> Roflnqulsliod By: te: Time'rf Recefve Date: Tlma' <br /> Refinquishod By. Date: Time: Received By: Date: Time: <br /> Relinquished By: Date: Tim u., Received By., <br /> Date: Time; <br /> Were Samples Received in Good Condition: L7Yes {J No Samples on Ice? Yes U ND Methad of Shipment_ Page. 01•- ---•-- �- "' <br /> To lea oompfelod upon recorpt of report: -- <br /> 1)Waro tho analyses raquestad on ilia Chain of Custody reported? E$Yea D No if no,witai analyses aro Mill needed? <br /> 2)Was the ri Issued within the re uested turnaround tim V ❑Yes No It no,what was th vurnaround time?. <br /> ,Approved by: 1 w,�, r s Signature:. f C/ Company.-, G�. Date:7` 03 - <br /> -- -.. .-� <br />